THE head of the inquiry into "appalling" failings at the Mid Staffordshire NHS Foundation Trust has called for hospitals that do not meet a "fundamental standard" to be closed and for staff to face prosecution.

Robert Francis, QC, delivered his 1782-page report into the scandal yesterday and issued a total of 290 sweeping recommendations for healthcare regulators, providers and the Government in a bid to improve patient care.

Years of abuse and neglect at the hospital led to the unnecessary deaths of hundreds of patients. But Mr Francis said the failings went right to the top of the health service, blaming the failures on a weak trust board which was focused on reaching targets, achieving financial balance and getting Foundation Trust status.

Mr Francis said: "This is a story of appalling and unnecessary suffering of hundreds of people. They were failed by a system which ignored the warning signs and put corporate self-interest and cost control ahead of patients and their safety.

"We need a patient-centred culture, no tolerance of non-compliance with fundamental standards, openness and transparency, candour to patients, strong cultural leadership, caring compassionate nursing, and useful and accurate information about services."

Families of patients who died at Stafford Hospital have called for heads to roll at the NHS, while campaigner Julie Bailey, head of Cure the NHS, demanded the resignation of NHS chief Sir David Nicholson, as well as Royal College of Nursing chief executive Peter Carter.

In Scotland, Professor Brian Webster, chairman of the Scottish Heads of Academic Nursing and Allied Health Professions, said that the report would be studied in detail.

In the House of Commons, Prime Minister David Cameron apologised for the "truly dreadful" mistreatment and neglect at Mid Staffordshire NHS Trust, and announced the creation of a Chief Inspector of Hospitals.

The watchdog will have responsibility for a regime of inspections which are an investigation into "whether a hospital is clean, safe and caring, rather than just an exercise in bureaucratic box-ticking".

Lyn Hill-Tout, the new chief executive of Mid Staffordshire NHS Foundation Trust which runs Stafford Hospital, apologised unreservedly for failing in its primary responsibility "to keep patients safe".

She said: "The report is rightly damning of Mid Staffs at that time. We have learnt the hard way. We have learned from that experience and, through listening to the inquiry witnesses, our patients, staff and local community, we try every day to continue to improve the care we provide."